Facilitation techniques for the upper extremities RHS 323 lecture 3 Prepared by Mrs: Muneera Al- Murdi

Facilitation and reinforcement Unilateral patterns: The initial position of the physical therapist showing the lengthened range of the pattern and the ending position showing the shortened range of the pattern.

Facilitation and reinforcement The manual contact in each movement are optimum for the specific pattern. The spiral characteristic of the pattern is shown by the dotted lines placed medially or laterally on the extremities. All information concerning a specific pattern is given for left or right extremities, or trunk and neck motion to the left or right.

Facilitation and reinforcement Components of motion: Description is from distal to proximal in accordance with normal timing. Normal timing: May be used with the maximal resistance or may be performed as free active motion without contact with the physical therapist.

Facilitation and reinforcement Timing for emphasis: Alters range of motion of the proximal pivots when distal pivots are emphasized. Commands: Preparatory commands, must be varied in accordance with the age level and abilities of the subject to cooperate. Action command, may be repeated as necessary in order to stimulate the patient to further effort.

Facilitation and reinforcement Pattern analysis: The motion components and the major muscle components are presented from proximal to distal in keeping with anatomical description.

Facilitation technique of upper extremity Flexion-adduction-external rotation (D1 fl) with elbow straight. Antagonistic pattern straight) pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

D1 fl, with elbow straight.

Flexion-adduction-external rotation (D1 fl) with elbow straight.

Facilitation technique of upper extremity :Pattern analysis Scapula motion components major muscle components: serratus anterior. Shoulder Motion components Major muscle components: pectoralis major, deltoid, coracobrachialis, biceps brachii.

Facilitation technique of upper extremity Forearm. Motion components major muscle components (supinators muscle) Wrist Major muscle components ( flexor carpi radialis, palmaris longus)

Facilitation technique of upper extremity Flexion-adduction-external rotation (D1 fl) with elbow flexion. Antagonistic pattern straight) pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

Flexion-adduction-external rotation (D1 fl) with elbow flexion.

Facilitation technique of upper extremity D1 fl, with elbow extension pattern. Antagonistic pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

Facilitation technique of upper extremity D1 ex, with elbow straight, extension, flexion pattern. Antagonistic pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

D1 extension with elbow straight

D1 ex, with elbow extension

Facilitation technique of upper extremity D2 fl, with elbow straight, flexion, extension pattern Antagonistic pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

D2 fl, with elbow straight patttern

Facilitation technique of upper extremity D2 ex, with elbow straight, extension, flexion. Antagonistic pattern Components of motion Normal timing Timing for emphasis Manual contact Commands Pattern analysis

D2 ex, with elbow straight

D2 ex, with elbow flexion